Tokyo, Japan Molly Wingfield

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Tokyo, Japan Molly Wingfield

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Presentations text content in Tokyo, Japan Molly Wingfield


Tokyo, Japan

Molly WingfieldJanuary 29th – February 24th, 2017


Tokyo Background

Most populous metropolitan area in the world (13,617,445 people, additional 2,500,000 during the daytime)

Capital of Japan, one of 47 prefectures

51 of Fortune Global 500 companies

Famous for shopping, unlimited culinary options, cherry blossoms, Godzilla, and anime

Ranked #1 for best overall experience, nightlife, shopping, public transportation, cleanliness of streets (TripAdvisor)

Ranked #1 most livable city in the world (Monocle magazine)

By far the most Michelin stars of any city in the world


Tokyo Medical University

Located in Shinjuku

Small hospital


work day lasts from 8AM to 5PM, with a morning and an afternoon teaching lecture

High proportion of

HIV and AIDS patients


Learning objectives

To understand the prevalence and incidence of HIV and AIDS in Japan, specifically Shinjuku Ni Chome in TokyoTo examine the history and foundation of the Shinjuku Ni Chome area of TokyoTo identify barriers to care for HIV and AIDS patients living around the Tokyo Medical University area


15 minutes from Tokyo Medical University

Originated as an area of legal prostitution

Transitioned to gay and lesbian bars after prostitution became illegal in 1957

Largest conglomeration of gay bars in the world

Developed into a cultural center for gay film festivals, AIDS awareness vigils, gay pride festivals, and community support organizations



HIV prevalence and incidence increasingReported cases doubled from 2000 to 2014

Decreasing in all other industrialized nations

Only 4.2% of cases are in


Missing information from reports may downplay HIV epidemic in Japan (national prevalence and incidence in the general population and AIDS-related death rate)

Tokyo has highest rates of infection


of people getting tested is droppingLack of appropriate sex education taught in schoolsMajority of cases are sexually transmitted (57.3% homosexual contact, 27.2% heterosexual contact)


Stakeholder interview

TMU sees many more HIV/AIDS patients than other Tokyo hospitalsTMU has special HIV department (Clinical Examination Department)1,300 enrolled patients10o+ new patients per year

More training/experience than any other hospital in Japan

Majority of HIV cases in Tokyo are from heterosexual contact

Barriers to care for HIV patients

Financial/insurance issues aren’t really a barrier

Stigma and discrimination are potential barriers

Lack of understanding of importance of the disease is potential barrier for the general public

Prevention attempts thus far haven’t been extremely successful



Revision of AIDS prevention guidelinesImprove HIV counseling and testingSet goals in regard to HUV testing for specific populations

Work with NGOs regarding measures for specific populations

Improve collaboration with community-centered core hospitals

Awareness campaigns

Stop AIDS Strategy government campaigns

Television commercials

HIV Awareness Week

Reduce stigma and discrimination Temporary HIV testing centersAccessible prenatal care and HIV testing



HIV rates are higher in Japan than the U.S.HIV/AIDS continues to be a growing problem in JapanSome interventions exist through the government, although they have not been overly successful yet

Education of the public will be very important in order to curtail the epidemic

The main barriers to care involve stereotypes and lack of public knowledge of the disease


Most Profound clinical experience

Witnessed many residents and doctors scrub in for

interventional radiology


wearing only these sandals on their feet

Some covered the sandals with mesh surgical booties


Most profound cultural Experience

Meeting the family of the Japanese exchange student whom lived with my family for a year while I was in high school

Toured popular Tokyo destinations with them

Visited their house in Ibaraki Prefecture

Saw Naohiro’s grade school, high school, home, and bedroom (with pictures of my family’s dog still displayed)

Visited the city’s temple




Anthony S. DiStefano. HIV in Japan: Epidemiologic puzzles and ethnographic explanations. Population Health. December 2016. 2:436-450.Chicara


. HIV/AIDS awareness in Japan still lacking.

Japan Today. September 6, 2014. Accessed March 15, 2017.


, A.,

Taira, R., Yokomaku, Y., Koibuchi, T., Rahman, M., Izumi, Y., and Tadokoro, K. The HIV care cascade: Japanese perspectives. PLos ONE. March 20, 2017. 12(3). Nakanishi

, Y., Saito, N., Morita, R.,


, Y.,


, N.,


, M. HIV/AIDS counseling services for foreigners at the Shinjuku Public Health Center.





. May 19997. 44(5):391-399.

Report to UNAIDS – HIV/AIDS trends in Japan. April 2016. Accessed February 19, 2017. file:///C:/Users/Molly/Desktop/Japan/UNAIDS%20report.pdf

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